Search this site

Find affordable health plans

About our health insurance quote forms and phone lines

We do not sell insurance products, but this form will connect you with partners of healthinsurance.org who do sell insurance products. You may submit your information through this form, or call
1-844-385-76091-844-961-0503
to speak directly with licensed enrollers who will provide advice specific to your situation. Read about
your data and privacy.

The mission of healthinsurance.org and its editorial team is to provide information and resources that help American consumers make informed choices about buying and keeping health coverage. We are nationally recognized experts on the Affordable Care Act (ACA) and state health insurance exchanges/marketplaces.
Learn more about us.

In 2018, Utah voters passed Proposition 3, delivering Medicaid expansion to the state. Partial expansion took effect in April 2019 and full expansion took effect in January 2020. A work requirement was imposed but it was suspended amid the COVID-19 pandemic.

More than 400,000 Utah residents are enrolled in Medicare. About 40 percent of that population had Medicare Advantage plans in 2020.

Utah’s health insurance marketplace

Utah uses the federally run exchange (HealthCare.gov) for individuals.

Open enrollment for 2020 health plans has ended, although Utah residents with qualifying events (including loss of employer-sponsored coverage) can still enroll or make changes to their coverage for 2020. The next open enrollment period, for plans effective in 2021, will begin November 1, 2020.

For 2020, BridgeSpan rejoined Utah’s exchange, after exiting at the end of 2015. Molina rejoined the exchange in 2019 after exiting at the end of 2017. So Utah’s exchange has gone from having just two insurers in 2018 to having four insurers in 2020: Molina Healthcare of Utah, SelectHealth, Inc., University of Utah Health Insurance Plans, and BridgeSpan (some have limited coverage areas, so plan options vary from one part of the state to another).

Does Utah have a health insurance CO-OP?

The ACA contained a provision that provided funding for the creation of Consumer Oriented and Operated Plans (CO-OPs), and more than $2 billion was awarded for CO-OP creation in 22 states. Utah’s Arches Mutual Insurance Company received $89.6 million.

As of early 2015, there were 22 CO-OPs operating in 23 states. By the end of October 2015, however, Utah’s CO-OP delivered the news that it would cease operations at the end of the year. As of 2018, all but four of the original ACA CO-OPs had closed, although those four have continued to operate ever since.

Medicaid expansion in Utah

Medicaid expansion became available as an option for states in 2014, but Utah was among the states that refused to accept federal funding to expand Medicaid coverage to more low-income adults.

But in 2018 mid-term elections, Utah residents voted for passage Proposition 3 with 54 percent of voters supporting the expansion. The ballot initiative directed the state to fully expand Medicaid, as called for in the ACA (ie, to people with income up to 138 percent of the poverty level)

This meant there was no longer a coverage gap in Utah. But CMS rejected Utah’s request to receive full federal funding (ie, a 90/10 federal/state split as of 2020) for the state’s partial Medicaid expansion, so Utah was only receiving their normal federal match rate for the partial expansion group in 2019. Ultimately, Utah did fully expand Medicaid as of January 2020, although a work requirement also applied at that point. The work requirement was soon suspended, however, as a result of the COVID-19 pandemic.

Short-term health insurance in Utah

Utah state regulation of short-term health insurance plans is stricter than the new federal rules regulating short-term policies. The maximum duration for a short-term health insurance plan in Utah is 363 days and the policies cannot be renewed.

Has Obamacare helped Utah residents?

Utah has not exactly embraced Obamacare, but the state’s uninsured rate has still fallen significantly since the law was enacted. According to U.S. Census data, 14 percent of Utah residents were uninsured in 2013, and that dropped to 8.8 percent by 2016 — although it increased to 9.4 percent by 2018. Medicaid expansion has likely reduced the uninsured rate in 2020, and is particularly important in the midst of the COVID-19 pandemic as people lose their jobs and employer-sponsored health insurance.

Utah and the Affordable Care Act

Utah initially took a unique approach to running the exchange. In a compromise with HHS, the state ran its own “Avenue H” small business (SHOP) exchange, which pre-dated the ACA, while HHS ran the individual exchange.

But the state eventually decided that it would be more cost-efficient to switch to the federally run SHOP exchange and that transition was made as of 2018.

Gov. Gary Herbert has been generally opposed to the ACA, but had been looking for a way to expand Medicaid for several years, noting that “doing nothing is not an option.” The vast majority of Utah’s residents favored the governor’s approach over no expansion at all, so it was not surprising that the ballot initiative to expand Medicaid passed in 2018.

Does Utah have a high-risk pool?

Before the ACA, individual health insurance was underwritten in nearly every state, including Utah. This meant that pre-existing conditions could prevent an applicant from obtaining a policy, or could result in higher premiums or pre-existing condition exclusions.

Now that all health insurance plans are guaranteed issue, high-risk pools are largely obsolete. HIPUtah coverage ended on December 31, 2013, and members were able to transition to guaranteed issue coverage through the exchange instead.

Medicare in the state of Utah

As of early 2020, there were 407,380 Medicare enrollees in Utah. About 40 percent were enrolled in private Medicare Advantage plans, and the other 60 percent were enrolled in Original Medicare.

State-based health reform legislation

SB96 was enacted in Utah in 2019, after voters approved a ballot initiative in 2018 calling for full Medicaid expansion. The legislation reiterated the state’s proposal to expand Medicaid only to those earning up to the poverty level, keeping people above that level on subsidized private plans in the exchange instead. Ultimately, however, full Medicaid expansion took effect in Utah in 2020. The work requirement that initially applied was suspended in April 2020 due to the COVID-19 pandemic.

Scroll to the bottom of this page for a summary of more state-level health reform bills in Utah.